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#16 Fencing, NHS Training and Recruiting Leaders

Summary
This week Alex is joined by Danny Ryan who is a former member of the Great Britain Fencing team. Danny currently works as a consultant at Russell Reynolds Associates, a global leadership advisory and search firm. Danny has particular expertise at the intersection of healthcare, education and technology, and is a trusted advisor to senior management as they navigate a rapidly changing industry landscape.
Danny is also a former Specialist Registrar in trauma and orthopedic surgery in the National Health Service, and previously worked in primary care, trauma centers and clinics across the UK.  Danny holds a BA in experimental psychology and an MB B Chir in clinical medicine, both from the University of Cambridge, as well as a postgraduate certificate in medical education from Cardiff University. He is the President Elect of the Federation of Orthopaedic Trainees in Europe and a Young Subcommittee Member of the European School for Trauma and Orthopaedics, as well as a Fellow of the Royal Society of Arts and a Member of the Royal College of Surgeons. 
Danny and Alex discuss training and performance in fencing, scaling training and education in healthcare and the characteristics that fine a strong leader.
Tweet Danny: @DannyJohnRyan
Tweet Virti: @virtimed
Contact Virti: https://virti.com
Transcript

Alex (Host):

I'm joined on the podcast this week by Danny Ryan, who's a consultant at Russell Reynolds Associates. Danny's a member of the firm's global healthcare sector, based in London, working at the intersection of healthcare and education and technology. Danny's got an amazing background, having worked in the NHS as a trauma and orthopedic surgeon, and has a specialist interest in medical education, being a member of Royal College of Surgeons, the Academy of Medical Educators, and an associate founding fellow at the Faculty of Medical Leadership and Management. Prior to this, Danny trained at the University of Cambridge, where he was a member of the GB  fencing team.

Alex (Host):

We cover everything from performance in sport through what he learnt in education training throughout his time in the NHS, and then finish up by talking about hiring practices, leadership, and what drives high performance organizations.

Alex (Host):

Hi, Danny. How are you doing?

Danny Ryan:

Hi, Alex. Yes, good, thanks. Thanks for inviting me along.

Alex (Host):

No worries at all. Great to catch up. I thought we'd just kick things off by you just introducing yourself to the listeners and telling everyone a little bit about your amazing background.

Danny Ryan:

Perfect. So I'm not sure I'd call it amazing. I would definitely say that this is my first time on a podcast, so I should probably get that out in the air early on. So if we're talking about feats of human performance, me making it through is going to be one of them. But no, so I guess, starting at the beginning, I grew up up north in Newcastle, went to a school where sport was very important, so that was probably what first made me think about performance. Always did a lot of team sports. It's a rugby school. So that really got me started. I would say, it was pretty average, but had the opportunity to also do an individual sport there, fencing, which stayed with me a lot longer. I had the opportunity to fence on a few age group teams, at GB level, as well as in the various National Championships and things above age group too.

Danny Ryan:

So finished up school, and as I was going through wondering what I wanted to do, one of my big heroes is my grandfather, he was a clinician, so he was an anesthetist, and he worked up in the northwest where Charnley, the father of the hip replacement lived. He worked with him quite closely. There was a lot of innovation at that time around the technology, and a lot of great things. Also a lot of disasters that they had. I grew up with some of these stories, and figured, "Well, that sounds like fun being a doctor, so I'll go to medical school."

Danny Ryan:

Attended Cambridge, did all six years there, which was absolutely fantastic. Got to work in an environment which was set up for success. You were given a college system where your meals were ready, you had rooms, you didn't need to go and search for accommodation. Everything was really geared around the intellectualism and being able to achieve and perform at your best. I continued with the fencing there on a very successful university team where most of us were on GB squad at the time. One of those went off to the Olympics. We had a couple of Commonwealth Champions out of it. So quite a high performing team. And at the time, our varsity rivals, Oxford, were pretty similar in terms of their makeup. So we had some great battles with them over the years, and various other universities. We also won the British Team Championships in 2007, a few of us, as well as the University Championships a few times. So that was, again, big thread running through.

Danny Ryan:

Then finishing up in 2009, went into the NHS, which was a very different experience in terms of support and how performance was looked at. Went on to orthopedic registrar training, which I should say, is how Alex and I know each other. We were working in the southwest together for a period before we went our separate ways. All through that time there were a couple of areas that fascinated me, particularly around diversity in surgery. At the time, only 4% of consultants in orthopedics were female. That was something that I really noticed, having come from other areas in medicine where we see two thirds plus sometimes of the workforce is female.

Danny Ryan:

One of the other areas was leadership. Ultimately, I went off to do one of the NHS Clinical Leadership Fellowships through the Faculty of Medical and Leadership Management, which was led by Bruce Keogh. They used to be known as the Keogh Fellowships. Probably started off as 10 or 11 of them, I think, and grew over the years. When I was there, there was in the mid-20s, and I think they've even developed more since then.

Danny Ryan:

But had several leadership roles in different organizations through the British Orthopaedic Trainees Association, the Federation of Orthopaedic Residents in Europe as well, where you had a really dynamic group who built up a network, probably of a couple of thousand residents across Europe. It was one of those things where you think the training standards are the same in every country, but actually as you start to look deeper into it and deeper into the ways that people are trained and measured, you realize that there's huge variation in consistency. You think we're one European Union, or were, I should say, post-Brexit, one European Union. But there are some countries there that have a completely different standard to the UK, and yet we think it's transferable.

Danny Ryan:

So one of the things we did was to drive education standards there. We worked with some of the bodies like WEMS, and our parent organization EFORT, which was the Senior Orthopaedic Society. So try and make advancements around how we look at performance. There were a couple of people I was very lucky to work with as well during that period, who were based here in the UK, one of whom was Lisa Hadfield-Law, who's an educationalist working with the British Orthopaedic Association and Royal College of Surgeons. The other one was [inaudible 00:06:17] who had written a number of books on cognitive psychology and performance in surgery. Having worked with sports psychologists in the past, it was an area that fascinated me, of, how do we create consistency in performance and results in surgery? An easy question to ask yourself, I think. But we're very [inaudible 00:06:44] in a number of areas as well.

Danny Ryan:

And as I say, ultimately went through the Leadership Fellowship with Bruce Keogh. Worked at a non-profit startup healthcare consultancy called Kaleidoscope, which is run by a brilliant brain, Richard Taunt, who had worked at the Health Foundation and in government, and brought a particular take and new outlook on healthcare and purpose. I suppose, purpose is the thread that's been through the last few years in my career, where after helping grow Kaleidoscope for a year or so, made the move to Russell Reynolds, where I lead our biopharma practice here in the UK. So working with everybody from early stage biotechs right through to big pharma, and with the investment professionals around the venture capital market as well. And of course, I do some work in services in private equity backed companies too. But my main focus is biopharma. It's very much a purpose driven organization, Russell Reynolds, where we will really look at our clients and their metrics and how we help impact those through improving the way that their organizations are led.

Danny Ryan:

So I'm going to stop there. That's been quite a long introduction, Alex. So I hope that was useful.

Alex (Host):

No, it's great. There's lots for us really to touch on and discuss. And before we come to Russell Reynolds or talk about surgical training, which obviously we can both talk about for hours and hours, but we're not going to... When I first met you, one of the really interesting things, and one of the things we connected on was obviously your sports background, because like me you're very, very sporty. Fencing, for me, when you were explaining about this was, obviously it's an Olympic sport, but it's fair to say it's somewhat niche. Could you talk a little bit about why you chose to pursue that and what it taught you, and what it taught you about both team based performance, and molded your future career?

Danny Ryan:

Yeah. So I guess, to go right back to the beginning, there's not many places where you can fence, is there? Let's face it, you're right, it's not like a football pitch, they're not in every corner. I was very fortunate that I went to a school that did it, so I had the opportunity, and also had a role model. So one of our family friends was on the cadet GB squad at the time, and I very much looked up to him and saw what he was doing, and heard the kind of places that he was going, and thought, "Yeah, that sounds like fun." So gave it a shot. It was the achievement that really got me into it, thinking, "That looks like it's a great plan, traveling the world and doing all these bits and pieces." I mean, the reality is, it's quite different once you get into a sweaty sports hall with 100 other men.

Alex (Host):

Although you do get a sword as well. Let's not forget.

Danny Ryan:

Yeah, you get more than one sword actually, which is helpful. So what does it teach me? I suppose, as I say, my sporting career really started with rugby, and that was a team sport where everybody had their own role. So it was very rare that you would, second row, which is where I spent most of my time, kick the ball, or be expected to take the last kick at goal that might win a game. I was there for jumping, making big hits, and scrummaging, that was it. You learn to be part of something that was bigger. That, for me, was one of the parts. And I knew what my job was and how to execute it.

Danny Ryan:

I suppose the thing that really hooked me on fencing was just the huge variety. You are on your own. There's so many different variations of actions that can take place. Intellectually, I found more of a challenge in it. It's funny when you look back at the level of maturity that you have, and the kind of analysis that you do. I remember somebody saying to me, "You should keep a book of fights, and what happened, and what went wrong, and what you would change, and how you would do it." Being about 15 at the time, I thought, "That sounds really boring. Why on earth would I do that? I just want to get out and fight and win." Actually, I wish that I had the patience to do it, because I look back now, and that was one of the big lessons that I learned, was about preparation, not just for that fight in that moment, but actually the days leading up before, and how you then warm down after and how you build up for the next battle.

Danny Ryan:

If you think about Olympics, these things work in cycles. This is one of the fascinating things, for me, I think, as we look into future careers as well is, you work in these cycles in sport where you have a competition every couple of weeks, so it's about getting your training right for that. Are you physically prepared? Are you over-trained before the competition? Are you under-trained? Are you tired? What are the factors that you learn to control around that? And that's years and years of experience. I still don't think I ever really had that right. There's a lot more science in sport now. And as I see people coming through, it's a lot less amateur and more evidence based. We didn't really have that at the time.

Danny Ryan:

But then when you compare that to working, I mean, we've both worked in surgery where you were operating maybe three or four days a week, and you had to be at your absolute optimum all the time. So how can you bring those two experiences together? I suppose, the way that I look at it is that the fluctuations and the ups and downs are probably lower on a day to day basis, but they're still fundamentally the same. So it's making sure that you go to bed at the right time, making sure that you eat the right food, making sure that you have the right environment for sleeping, all of these things.

Danny Ryan:

I suppose, again, what that brings me round to is, one of the big lessons that I learned around rest. So I had a sports psychologist that I worked with. He used to work with the English Cricket Team at a junior level. But he always said that you have to have a day a week where you don't think about whatever it is that you're doing most of the time, whether it's training or work, whatever it is, you need that mental reset. That is something that I've really brought through with me. Again, it's about, what are those little things that you do in your day to day that help you to find that balance, so that you can manage those little ups and downs in the day? Versus the big cycle that we see in sport, where it's about really preparing for that, how do you make sure that you're right for that surgery list on that day? Or that meeting coming up in the future? So that was something, the mental preparation, the physical preparation.

Alex (Host):

I think it's really interesting. Because even when you were just talking about when you were 15 and noting stuff down in a notebook, that's very similar to what we were taught when you're operating, so reflecting on each operation. And equally, if I'm working with any teams or organizations, or anyone internally at Virti, one of the big things is about reflective practice and continuous improvement, and actually documenting things down.

Alex (Host):

I suppose, one of the really interesting things with fencing is, as you say, it is very intellectual as well as being a physical sport. Can you just speak to a little bit about the underlying rules and the goals and how that plays into how you train and how you perform?

Danny Ryan:

So it's really quite simple. If you ever watch fencing it looks like the most complicated thing you'll see. But it's fundamentally about hitting the other person before they hit you, and having right of way and priority. There's various ways of doing that, whether you hit someone else's blade out of the way, or they attack you and miss and then you hit them. It's all about, how do you develop that priority?

Danny Ryan:

I suppose, in terms of the training, my coach was from Hungary, he coached a very successful team to Olympic medals. And he had a system, he had his processes, and there was a cycle that you could work through. So that even if you weren't physically training at the time, you could still... And one of the things you talked about, reflective practice. But this comes down to deliberate practice, actually setting the time aside to think about something in a constructive way.

Danny Ryan:

I think it's Malcolm Gladwell's book talks about 10,000 hours of practice. But 10,000 hours of practice is pointless if, if it's golf, you just go and hit a ball, you're not learning anything, you're not learning what adjustments you need to make. So deliberate practice is more a concept of going out with a purpose to be able to really achieve the result that you want. Reflective practice comes into this as the next step to complete that cycle. But that was one of the things in fencing that we could do, was the physical preparation, and that deliberate practice, the muscle memory, but also then the tactical memory as well, and the strategic piece too.

Alex (Host):

Yes, super interesting. For preparation for some of the bigger competitions, certainly I guess at GB level, or at any time, how much pressure was that on you to perform in those environments? And how did you handle that?

Danny Ryan:

So one of the beauties of fencing is that there's not a lot of money at stake. I mean, you spend money, but the prize money is not there, you're not being driven... I suppose this again comes back to purpose, doesn't it? In terms of pressure and why you're doing it. For me, a lot of it was social, and a lot of it was the enjoyment of being with other people, with my friends. And sometimes the result was secondary, which isn't right. But in terms of the bigger competitions, I think the perfect example is the varsity match every year. If you think about a season, there's multiple points where you can pick up wins, pick up your points for your ranking. And if you maybe don't quite get the result that you want, well, that's okay, you can maybe next time get better results and you just push harder and do better preparation. Whereas, the varsity match was a one off piece.

Danny Ryan:

The psychology of it was very interesting because, I watched a lot of extremely good fencers crack under that pressure. It was a one off. If you were lucky you got three shots at it. If you were injured, you might get less. If you weren't selected, you might get less. But the whole pinnacle of the year came down to that. So actually your training cycle became slightly different to how you've done it all your life, where it was different from a regular season. So as you got up to that, we were doing... I remember when I was captain, we were particularly challenged that year, because we'd lost a lot of good people, Oxford were particular stronger, and going into it we lost to Oxford twice.

Danny Ryan:

So actually it ended up being that the preparation we did, we went away on a training camp to Hungary, we spent a lot of time together as a team, we talked about tactics a lot. I tried to, I don't know how successful it was, but tried to learn the different levers to pull on the members of the team to get the most out of them on the day. Ultimately, as I say, I don't know that necessarily I did that that well, but we managed to win the match by one point. The score was 111/110. So very fine margin. Having walked away with it a couple of years before. That was all about how you prepare for this cycle. There was enough inspiration, but how did you motivate people to believe that we could win, having already lost two matches?

Danny Ryan:

The funny thing was, as I came out of my first three years, which were hugely successful and we were pretty much undefeated in my first two years, and then we had my captaincy where we lost the British University for the first time in six or seven years, won the varsity match, and came off the back of that into a new team where there was some turnover of people leaving at the natural end of their university careers. We got a very strong team in, and my role changed. I'd been the senior statesman on it, and we had these young guys coming through who, when I was on the under-20s, they were like 14, 15, and they were probably getting better results than me abroad.

Danny Ryan:

So there was a learning that I had to do around what my role on the team was. So there was my personal performance. And when you were the captain, you always felt that that was under the most pressure. But actually, then the pressure changed. It was about helping other people perform at their best, because when you're young you think the best person on the team is the leader, they're not, that's not how life works. It was a real eye-opener to me a couple of times when I saw that it didn't really matter what I did. My score would fluctuate a bit. But actually, it was much more about getting people to perform at the top of their game, because that was ultimately going to give us a better result than me trying to perform at my best. So if I could spend 20% of my energy making two other people even better, then that was much more worth the while than the hit on my personal feeling about how I'd done or how people view me.

Alex (Host):

Yeah, I mean, super interesting. So many parallels to business and healthcare as well. I guess, fast forwarding things to when we first got to know each other and met in a healthcare capacity was during our surgical training in the NHS. Now you, a little bit like me, obviously have a passion for education training and a bunch of other stuff. One of the things you mentioned earlier was, specifically in healthcare, about diversity and teams. I guess, just continuing on from that conversation around fencing and how you need to basically make sure that the whole team is working together and is leveled up as much as possible, can you speak to what you saw when you came into trauma and orthopedics, and why having a diversity and a diverse workforce as a real passion for you?

Danny Ryan:

So I think there's a couple of things first of all, which is that, I suppose, when you look at teams in the NHS it's a very different kind of environment. It is teams that are put together on the day. There's rotas. There's different skillsets. I mean, think back, how many times did you work on the same team in theater during your career?

Alex (Host):

Right.

Danny Ryan:

Yeah, barely ever. So there's a slight difference in terms of how those teams work and how they need to be motivated. But look, I think there's good evidence out there that if you change one person in the room, so if you have a uniform makeup in the room and you change one of those people out and bring in a diverse outlook, that it will change the entire conversation. And that's incredible, isn't it? They've done this at the board level. You can't believe that it makes that much impact, but it does. I've seen it, I think. There was a lot of behaviors that went unpunished in certain aspects of the NHS where they were male dominated. Honestly, if you put a woman in the room, I think there were a lot of things that would change, people behaved the way that they would, and it created a much better environment. That was my observation.

Danny Ryan:

We're not just talking about gender diversity here, but ethnicity, sexuality, whatever it is. This is something that we work on in Russell Reynolds a lot, is the diversity and inclusion piece, helping organizations look at where they are on their journey around this, and how can they get to the next step? As I say, this is all very observational from earlier in my career in surgery, and I'm sure you probably noticed this as well at various times. But we had a couple of really excellent registrars on the rotation who were women. And I remember, one day, I think we were late, I was with my consultant, one of those registrars was with her consultant, and we went into the changing rooms, obviously three guys, we were in there probably about 20 minutes, laughing and joking and chatting, and came out. And I remember her face, standing outside, obviously having waited for a while for the three of us, and then seeing that there was that kind of bonding going on in the changing room. You think about the impact that that has on a person. You think about career progression. You think about flexible working.

Danny Ryan:

I don't think we're good enough yet, particularly in surgery, at bringing people along. I think the inclusivity piece isn't there.

Alex (Host):

Yeah, I mean, really, really interesting. I think the stats you alluded to at the beginning of the conversation were that, certainly if you roll back the clock five, 10 years, even more so than now, across the surgical specialties in particular in medicine, there is a real lack of females who are practicing in the specialty. It is a very male dominated specialty.

Alex (Host):

What were some of the things, I guess, on the training side and the education side, that you really focused on? Because I know that your background, very similar to mine, a lot of it was about powering up the trainees and trying to get people to be as good as they possibly could be, both with elements of technology, but also just with elements of better training and better access to training. Obviously, you've got a background in some of medical education practices and academies and things like that, as well as working for the British Orthopaedic Trainees Association. So it would be great to just get your insights on the training side as well.

Danny Ryan:

Yeah. One of the things you talked about just before was flexibility in working. We had some time set aside for education, I think it was an afternoon a week, where you could do pretty much whatever you wanted. We had some lectures, which was great, and there was a program put on for us. But not all rotations had that. So even within the country there's a huge variability there. If you look at the geographical distribution of the rotations, we were centered on Bristol, I was in Cheltenham a lot, we both were up there in Gloucester, people were in Swindon. Sometimes that drive on a Friday afternoon to get to Bristol for teaching took an hour and a half.

Danny Ryan:

I remember you having a conversation, I certainly had the conversation at the time with the training leads, that, why not do this remotely? We've got Skype, we've got various pieces. People are missing out huge chunks of their training. So this comes down to the technology. We had the capability at the time, but weren't really using it. I don't think people really knew how. Everyone assumed that if you were on a screen for a period of time, then you were probably going to be quite bored, or people wouldn't be engaged. Whatever it was.

Danny Ryan:

I think what we have got to now, and as I look at what's coming out of the coronavirus pieces, that this is where we needed to be five or six years ago. What has changed? It's just necessity. We've had the tools. I think some of the other areas of education tying into the technology piece are certainly around the work that Virti's done, I remember, I can't say I had a big hand, but we worked closely at the beginning of this, and the opportunity to create a tool where people can be educated remotely, not only in this country, but abroad, is phenomenal.

Danny Ryan:

One of my very good friends from university, Waheed Arian, he came over from Afghanistan in his late teens and came to Cambridge, went to Trinity Hall, and studied medicine, went off to London. Now he's set up a telemedicine charity that works in the Middle East. He's an A&E doctor. He still practices. But he has leveraged that technology to be able to help people in his home country and give them the support and education that they wouldn't have dreamed of not that long ago. And it's so simple through his smartphone.

Danny Ryan:

So I bring it back to the experience that I had, that we had, I think I felt a lot of frustration at the time that there was these tools there that we couldn't use. Again, there was a lot of evidence around using, for example, simulation labs before knee arthroscopies. If you got the surgeon in and they did a dry run through, then they were more efficient and got better results at the end of the day, than if they went in cold straight to their first knee arthroscopy. That was one example, the muscle memory piece. And Touch Surgery, there we go, that's a company that's used this principle of deliberate practice in order to really make training and education accessible to the masses. Anyone can go on there and practice a carpal tunnel release or a knee replacement or whatever it is. There was huge scope, and I felt that we couldn't quite make it. And the argument always came down to money. So that was where the issue was, I think. Or the perception of cost and not the returns.

Danny Ryan:

Alex, I'll turn it over to you. You can talk about the returns from this kind of remote education far better than I can.

Alex (Host):

Yeah. I mean, just getting back to one of the things that you said about the equity of access, is really one of the key things. Because certainly when we were both training, I think it's fair to say that healthcare professionals in general, especially in orthopedics and surgery, and some of the very competitive specialties, my observation was always that the people that are selected into those high-performing areas basically work their butts off on a day to day basis. In healthcare, one of the ways they do that is gaining access themselves to high quality training environments. So you and I were both very, very fortunate to work for Chris Kerwin, who is a Silver Scalpel winner in the UK, probably one of the best surgeons in the country, if not the world, fantastic trauma surgeon. His work ethic is just absolutely phenomenal.

Alex (Host):

But going back to what you said earlier, not everyone has the opportunity to go and train with him. And surgery itself is an apprenticeship specialty. So getting in your 10,000 hours or whatever the number of the week is to be adequately trained, is not going to be equal for everybody. Because some people are going to be limited by geography or resources. Other people are going to have these fantastic training opportunities. And that leads to some people being better than others, through serendipity and happenstance really, which isn't really fair.

Alex (Host):

Then equally, even for the people who have been exposed to the best type of training possible, it's not that repeatable, so every case is going to be different. You're going to miss out on things like tips and tricks from surgeons, non-technical skills, lots of these other things that actually make up surgery other than actually operating. I guess, for me, it was always about, how can you scale that and how can you quantify objectively to reduce that element of variability? And in healthcare, to therefore improve patient safety?

Alex (Host):

But in any kind of setting, in the business setting, having that access to [inaudible 00:30:55] training is going to be hugely beneficial to anybody.

Alex (Host):

One of things you mentioned earlier, Danny, was some of the things that you were doing at a national level, whether it was through the Leadership Academy or whether it was through the British Orthopaedic Trainees Association. It would be really interesting just hearing your thoughts on how to actually implement things centrally for a large workforce like the NHS or orthopedics, and how that went, and what you learned from it.

Danny Ryan:

A nice easy question there, thank you, Alex. Yeah, centralization. Somebody said to me recently that the NHS is 100 different doors with the same logo on, when it comes to procurement. And I think that's very true. The way that the budgets split up between the different training regions, they have their own way of spending that budget. I think that that was the ultimate challenge to centralization. Unless there was an approach from the deaneries together, you're never going to be able to get that kind of uniform training experience. So this is all about the patient.

Danny Ryan:

Maybe we're asking the wrong question about centralization. Maybe it should be about patient needs in different areas, as we move to value based care, population based care. Actually maybe we need to reframe the question about how we go about implementing this kind of technology. Because what we've seen is rapid adoption of different methods in the NHS now. And yes, from a pricing point it might make sense to centralize. But how are we going to get there? I don't know. I'm not going to answer that question. I don't think we'll get to the bottom of that today. But within the constraints that we have at the moment actually, should we be looking at more tailored solutions for different areas?

Alex (Host):

Yeah, I mean, really, really great points. Just touching on what you mentioned there with the European Working Time Directive, obviously in Europe that effectively was brought in to protect trainees and ensure that they were getting sufficient rest and they weren't working beyond their means, as they had been in the past, or perhaps residents that are listening to this in the US might be able to sympathize with.

Alex (Host):

But one of the things that I was always took away from that was, in a training capacity, moving from something that is very much a quantity based training, i.e. doing lots and lots of the same type of procedure, or just being in work as much as possible, was then having to move over to the competency based training pathway.

Alex (Host):

What were your experiences, I suppose, of being in the middle of that? And how do you think that positively or negatively affected you training within an organization?

Danny Ryan:

I want to say that I'm younger than you so I didn't quite see that transition. But the truth of it would be, I just got my registrar job a year later, so I think I came straight in on the work based assessments.

Alex (Host):

I think, you being six months or eight months younger than me.

Danny Ryan:

I'll take it. So that's a very good question, because the e-portfolio, or the ISEP as it was called in surgery, was a big bone of contention. There was this lack of understanding of the theory and why we were doing it and what the value was. So we had this great remote portfolio that you could use anywhere. I say that, sometimes there were no computers in theater. But you could fill this in anywhere with your trainer, you could fill it in separately and reflect on it later with them. There was all manner of ways of using it, but it just felt, at the time, like another thing that was put on people, and a change without any kind of clear guidance. The evidence was all there, you just had to find it. Which is why I felt quite passionate about it and passionate about how you could use it to drive things. As I say, this goes back to my past experience in sport, where actually I didn't do that, and really did not have the right kind of learning curve as a result.

Alex (Host):

I think it's very difficult rolling something out nationally for every single person within an organization in a training capacity, because everyone learns slightly differently. And without having something that's personalized to people, it's very difficult to actually achieve adoption, because people don't really necessarily see the benefit straight away. And then actually, showing people that it is effective and helps them, can be very, very challenging also. So that buy in for the employee is absolutely critical.

Alex (Host):

Fast forwarding slightly, so having then made the decision to leave the NHS and move into jobs in strategy and then now Russell Reynolds, tell me a little bit about that decision, and then also what you're doing at the moment at Russell Reynolds.

Danny Ryan:

I would say that this comes down again to purpose and the purpose I feel and what drives me. So having spent a bit of time exploring the management consultancy route, because that's what all doctors do, right? If they're leaving the NHS, they think that they can be a management consultant. There was something about it that just didn't capture my imagination. I talked about Kaleidoscope a bit earlier, and it was a really unique organization. The way that it was run, the way that it worked, the clients that we worked with, and how they accepted slightly different views that we brought along, and the way that we ran events, or that the team were working at the time. So that was a really unique experience, and you developed a really strong relationship with people.

Danny Ryan:

But as I went and interviewed at management consultancies, I didn't feel that I was going to be the kind of person who could do a project, hand it over, and then not stay and see it implemented. So as I was exploring this, a friend introduced me to Russell Reynolds. I thought I was going for career advice, but as I had more conversations with people there, what I realized was that the thing that I'd been missing was impact at scale. And absolutely, there is huge value in doing one hip replacement at a time, one knee replacement at a time. But for me, it just didn't feel enough. As I was going through my career in orthopedics, I saw as narrower and narrower and narrower, and you would just end up doing cases of increasing complexity, but they would still be hip replacements.

Danny Ryan:

For me, somehow I didn't feel great inspiration in that. But talking to the team at Russell Reynolds and hearing about their purpose about improving the way that world is led, it really inspired me to think, "Well, actually, if I can help one biotech get a chief medical officer in who gets a drug across the line in oncology, that's going to effect far more patients than I ever could do in one operation in this time." So that, for me, was the light bulb moment that made me realize that it was the right step. And obviously, fortunately enough, it's a big step coming out of the NHS into this kind of industry, into a much more corporate environment, but I was very fortunate Russell Reynolds took the risk on me, and really helped-

Alex (Host):

Just to jump on that point, Danny, because obviously, the NHS, as with any healthcare provider, the services that we as surgeons are providing were amazing and obviously very, very rewarding for us, and we obviously took a lot of pride in everything we were doing. Do you think that point you made almost being valued or understanding the mission and goals of the company you're working for, do you think that the NHS really got that across to the employees in the same way that, say, a corporate in the private sector really pushes mission and vision goals?

Danny Ryan:

It's a very good question. I think there's one thing pushing goals and vision. And I've seen leaders in hospitals stand up and talk with great passion about what they're doing, about what the hospital's doing, what they believe. I think it's about making people believe that that is what it is. Some organizations in the corporate world do that very well, and others don't. I think the culture at Russell Reynolds is fantastic, it's an open place to work, people are honest. It's a feedback driven environment. There was consistency in everything I heard about the organization from everyone I spoke with, and I must have spoken to somewhere close to 15 people through the process coming in. It's a very rigorous process. It gave me plenty of time to think and ask the questions that I needed to. I could feel that consistency and approach in mission between the people that I spoke with, and that was really key to me.

Danny Ryan:

And you see it in pockets of the NHS. There are certain services that people would run through fire to work with the others and get it through. And unfortunately, there are areas which are less motivated than that. So again, it comes down to that consistency and uniformity. And look, it's such a big organization, so many people, multi-site, those sites are in various different states of repair or whatever. So it's a bigger scale challenge to take. But people will still rally behind that name. We've seen that and it's been fantastic, during this period, the clap for carers, and all those kind of things, and the way that other businesses have rallied behind NHS workers. You see it, and it's just a shame that we haven't seen more of it, I think.

Alex (Host):

Yes, it's a really great point. I guess, from your perspective at Russell Reynolds at the moment, and in your day to day job that you day where you're recruiting very senior, C-suite type executives into key roles in organizations. Can you just expand on that a little bit about what that consists of and why those roles are so key for some of these big organizations that you work with?

Danny Ryan:

It's leadership from the top. We work at executive and board level. The majority of my work is around that executive level. What you see is, you speak to leaders with a myriad of different styles, approaches, capabilities. There's a unique opportunity in our job to help an organization find that piece of the jigsaw. We have a team of business psychologists who have put together a leadership, I'll call it an assessment, I don't think that's the right term for it, but with Hogan, and we call it Leadership Spam. What we look at is the leadership capabilities, not in a binary way, but more in a spectrum. So people will flex their behaviors as leaders to be able to match what needs to be done at that time. And that's what we've seen during this crisis, is the really great leaders who have stepped up, who have shown the flexibility in their styles and the ability to transcend their, in quotation marks, "normal behavior" or tendency to behavior, in order to help take people through the current crisis that we're seeing.

Danny Ryan:

And we're in a unique position now seeing these kind of organizations going through this current time, because it's a crisis like never before. You might see one in your lifetime. But we've seen a financial crisis. Now we've seen COVID-19 as well. The importance of leadership and the ability to create the vision and keep people behind it, and bring people with you on the journey, that is, I'd say, what is a privilege to see in our candidates, and working with our clients.

Alex (Host):

From your experience having interviewed and worked with a number of very senior leaders in quite key positions, what would be some of the top commonalities and traits that you see in these individuals that you're putting in these positions?

Danny Ryan:

That's a very good question. I would say, top one is probably that ability to adapt to the situation. Things can turn on a sixpence, and you need a leader who can adapt to that and adapt their time. I think communication is another big one, the ability to know what is the right level and the right time, and also when to be quiet, I think that's a very important one that's often underrated is the time to know when to let others speak. And be humble, that's a big one. This is obviously aside from all the technical skills and experiences. The emotional intelligence, and I think, from last year a new term that I heard certainly, I think, is one that came out of Davos, is the learning quotient, the ability to keep learning.

Danny Ryan:

This is where we're seeing the most successful leaders at the moment, the ones who can learn, and implement the changes that they have understood. I think as we look to the next generation it's going to be about sustainability. That's where organizations are going to need leaders who can understand the longterm goals, disruptive innovation, longterm activation of the organization. Stakeholder inclusion, so being able to really, from the bottom of the organization to the top, bring voices together and help forge that direction forward. But also the multilevel system thinking as well, and being able to handle that high level of complexity.

Alex (Host):

You mentioned psychological tests. Hiring for any organization is incredibly challenging, getting the best people in possible to drive your organization forwards. Are there any other things that you might recommend companies look for when they're reaching out to hire individuals, obviously other than working with Russell Reynolds team? What kind of people?

Danny Ryan:

Well, it's a good question, and it makes me think actually of how we've been working in current times really, that question. We've done a number of pretty big hires across the firm for everybody from banks in Asia to healthcare companies, biotechs at C-suite level during COVID, and they've all been done virtually. Where we've really doubled down is around data gathering of people. So how do you go from a world where everybody was in the office and you've got to see somebody face to face to make a decision, to we're in a real crisis, the organization needs a leader, we don't know when this is going to end.

Danny Ryan:

We've been really working hard on using different data points. So whether it's soft referencing on people, or psychometric assessment, interview with our business psychologist in more detail. Further hard referencing as well, these kind of things, more steps to process, whatever it is to try and give people that confidence to be able to make the decision. And yes, sometimes it's still a sticking point, face to face meeting. But we're gradually opening up now and we've been working on various ways of having contracts in principle, offers in principle, that kind of thing, with candidates, so that when the doors open, they're good to go and we can really hit the ground running. So again, as an organization we've had to be agile in that. But what to look for next, I think the two big areas for me are diversity inclusion and sustainability. That's where we're certainly working hard to find what are those aspects within those two areas where we could say, yes, this person will be able to keep your business growing.

Alex (Host):

Once you've found these great people, specifically at Russell Reynolds, how do you onboard and train these people up very, very quickly to get them functional and high performing as quickly as possible?

Danny Ryan:

We will do the executive transition up. But I remember, I had a conversation recently with someone who had done their dissertation into this, but it was about, what's the executive transition down as well? That's something I think we need to think about is... This brings us back to the sports comments from earlier, where you see a lot of athletes who come out of very, very successful careers suffering with depression, various forms of mental illness. We don't look after people after they've come out of that top.

Danny Ryan:

I think it's very much the same for executives. People will go from running a company one day to being retired the next, and thinking about board roles but not really knowing where to start. Actually, it's that transition as well that I think we need to help people more as they come out of their careers, because they still have a huge amount of value to add. And what we've been driving in biotech particularly is the role of the board as a supporter for the CEO. So they're not there to set KPIs for the CEO. They're there as well to mentor that person and bring them through, and help them fill the gaps that they have.

Alex (Host):

I think it's so important. And as you say, it reflects back to what we were talking about right at the top of the conversation, which was around keeping people fit and healthy in these high performance roles, and making sure that, in a similar way to when you were training for fencing, that people are getting sufficient sleep, that they're healthy, that they're well, and that they're optimized as individuals on a health level, I think, incredibly important.

Alex (Host):

We could probably talk forever and ever about healthcare, training and everything. And we'll probably get you back on the podcast at a later stage to double down and speak in a bit more depth about some of these topics that we've covered. But just to wrap things up, could you give one or a couple of examples of human performance that you've seen either in your current practice or an external example that's really influenced you throughout your career?

Danny Ryan:

I'm actually going to give you one that hasn't influenced me throughout my career but has really inspired me in recent days, which is the key workers in this current crisis. You look at Age Care where the carers on the ground went from being afraid of their own health, of their residents' health, to going through what is a really traumatic time in terms of the rate of mortality we've seen in care homes. And to keep going through that and keep working through that, and keep delivering high standards of care.

Danny Ryan:

Equally in the NHS, the amount of time that people have had to down their normal tools, to keep going in a vein where you don't know how long this is going to last, with that uncertainty and that ambiguity, I'm phenomenally impressed. I think that that is one of the biggest feats that we've seen in terms of human performance for a long time. And it's ongoing. That absolutely blows my mind. Just the way that, as well, a lot of companies have pulled together to look at creating vaccines. We're seeing collaboration on a whole other level. Deals are getting signed in no time that would have taken months before. It just shows that when we pull together in healthcare as a community, it just shows what we can do, I think. But yeah, absolutely the key workers at the moment are just absolutely outstanding.

Alex (Host):

Yes, fantastic example, and quite neatly wraps up everything we've been talking about. So listen, it's been awesome speaking to you. If any listeners want to get in touch with you, have you got any socials or contacts through Russell Reynolds you want to give out?

Danny Ryan:

Yeah, I was going to give you my Twitter, I can't remember it. I think I'm @DannyJohnRyan. Also on Instagram there. But otherwise, you can find me through the Russell Reynolds website.

 

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